Inspection on 30/10/08 for Waxham House

This inspection was carried out on 30th October 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Waxham House 30/08/06

Waxham House 07/12/05

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Waxham House 1 High Park Road Ryde Isle of Wight PO33 1BP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mark Sims     Date: 3 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Waxham House 1 High Park Road Ryde Isle of Wight PO33 1BP 01983564326 01983564326 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Sanjay Prakashsingh Ramdany,Mrs Sandhya Kumapi Ramdany Name of registered manager (if applicable) Jamie Louise Bunter Type of registration: Number of places registered: care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Waxham House is situated within a residential area of Ryde and is a short journey by car from the facilities and amenities of Ryde esplanade and the town. Walking to these services and conveniences would, however, be beyond many of the clients accommodated at the home, a result of the distance, although public transport (buses) is accessible nearby. The premises is a large period town house, which has been adapted to provide residential accommodation with a lift to the first floor or chairlifts, which can be used to access both the mezzanine and first floors if required, the home having two separate landings accessible by different stairways. Weekly Fees are £443.00 Care Homes for Older People Page 4 of 32 Over 65 20 4 0 0 Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection was, a Key Inspection, which is part of the regulatory programme that measures services against core National Minimum Standards. The fieldwork visit to the site of the agency was conducted over seven hours, where in addition to any paperwork that required reviewing we (the Commission for Social Care Inspection) met service users, staff and management. The inspection process involved pre fieldwork activity, gathering information from a variety of sources, surveys, the Commissions database and the Annual Quality Care Homes for Older People Page 6 of 32 Assurance Assessment information provided by the service provider/manager. The response to the Commissions surveys was good, with six service user, one care staff and three health professionals returning surveys, prior to the report being written. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 32 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 32 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service and their representatives have the information needed to choose a home that will meet their needs. Evidence: Three service user plans were reviewed during the fieldwork visit. Each plan contained a detailed pre-admission assessment undertaken by the manager. One of the plans also contained a from known as a schedule 3 placement order, which is provided by the Local Authority and is a referral or assessment summary completed by the service users care manager and sent to the service in advance of the person being admitted to the home. Five of the six people to complete and return surveys to us (the Commission) indicate that they received sufficient information about the service prior to agreeing to move Care Homes for Older People Page 11 of 32 Evidence: into the home, the sixth person felt they did not receive this information but was provided with a contract and terms and condition of residency. Care Homes for Older People Page 12 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The manager states via the AQAA that: All our service users have an individualised and up to date care plan, as a result of the ongoing needs assessment. The care plans is devised with the involvement / agreement of the service user and is countersigned by those that are able. Our service users have access to other members of the multidisciplinary team, as required and according to their needs. After undertaking a risk assessment, service users who are able to self medicate are encouraged to do so, to promote their independence and for them to have some control over their well being. Care Homes for Older People Page 13 of 32 Evidence: We strictly adhere to the procedures, for the receipt, recording, storage, handling, administration and disposal of medicines. Three care plans were reviewed during the fieldwork visit and each was signed by the service user, as stated above, which acknowledged their agreement to the plan produced. The care planning system is based upon a modified Activities of Daily Living (ADL), which is a nursing model of health care. In addition to the care plans the assessment tool, used by the manager, also uses ADLs to identify peoples immediate health and social care needs. As both documents are designed around the one model of care the information gathered can be easily and readily transferred between the two documents and thus help ensure important information is not over looked. The care planning documentation or files also contain details appertaining to the service users health and welfare and identifies contact with external health and social care professionals. One of the three peoples records indicating that a General Practitioner had recently visited and reviewed the persons medication, which was being changed to help control giddy or dizzy spells. These records it was noted during the visit were not always accurate, one service users records documenting that the chiropodist had visited them in August but despite them being diabetic had not visited since. The manager felt this was not right and was able to produce a receipt following the chiropodist visit in September, which confirmed that the person was seen within six weeks of the last visit. The manager has undertaken to ensure this record is updated. Information taken from three, returned, health professional surveys indicate that the professionals generally feel the service users health care needs are met by the care service, two people ticking always and one usually in response to the question asked. A similar response was provided by the health care professionals to the question: does the care service seek advice and act upon it to manage and improve individuals health care needs. Care Homes for Older People Page 14 of 32 Evidence: The feedback from the service users is that generally they receive the support they require from medical services, four people ticking usually and two always in response to the question: do you receive the medical support you need. It was interesting to note that one the health care professionals, felt that staffs attention to the promotion of privacy and respect could be improved upon, the person commenting: care assistants vary in the attention they pay to this. i have to remind care assistants in all establishments about this and Waxham House is no exception. It is not however, any worse than anywhere else! The view of the people spoken with during the visit was that they had developed good relationships with the staff and that they were well treated and respected. Information taken from the service user surveys establish that the service users feel the staff listen to what is asked of them and act appropriately, five out of the six people ticking yes in response to this question, the sixth person opting not to complete this section of the survey. The care planning records maintained by the home also suggests that staff and/or the management are aware of the need to promote respect and ensure peoples preferred terms of address are documented on admission. A review was undertaken of the homes medication administration system, during which no issues of concern were identified, although the manager was asked to ensure that the safe being used to store controlled medication, when the home has any, is fit for purpose and compliant with the guidance set out within the Safe Custody Regulation, which are associated to the Medicine Act. The general approach to the storage of prescription only medications within the home was found to be safe, with a minimal stock of medication retained within the home. Records associated to the safe administration of medicines, the medication administration records (mar), the system for receipting or check medicines into the home and the records used to account for medicines returned to the pharmacy, were all in place and accurate. Each care planning file also contained a medications profile, which identified the medications a service user was taking and its effects, etc, and as and when required protocols were in place to guide staff on how and when to use these medicines. Training records indicate that staff are receiving training on the safe handling and Care Homes for Older People Page 15 of 32 Evidence: administration of medicines and that only those people to have completed training are permitted to dispense and administer medications. Care Homes for Older People Page 16 of 32 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their life style and supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: The manager states via the AQAA that: Our approach to the activities and routines of daily living are flexible and varied to suit service users expectations, preferences and capacities and we encourage our service users to exercise their right of choice of their meals and mealtimes, right to meet their family and friends when they want to, right to observe their privacy and involvement in social activities and daily routine of the home. Information gathered from the people spoken with during the visit largely confirms the managers statement, people discussing the homes activities programme, which they described as good and showing pictures they had painted at art classes. One person spoke of creating a calender, which could be sold and remarked that this had been discussed at a residents meeting, although the customer base for such a Care Homes for Older People Page 17 of 32 Evidence: product was thought to be small. The four ladies and one gentleman spoken with, stated that activities were ongoing daily and that often there was a puzzle in the sun lounge, which they could all contribute towards completing. One lady stated that books are brought in to her regularly, as it is known that she likes to read. The local church undertake regular visits to the home or people attend coffee mornings, etc that the local church running, the church being situated next door to the home. Families were also felt to be welcome at anytime and whilst talking to the service users a visitor joined us, confirming that she visits often and at varied times. Whilst in the lounge discussing activities, a service user pointed out that a schedule of activities was on display and that additional copies of the schedule were pinned up around the home. The manager also stated that staff often become involved in organising events or helping the external entertainers during their visits to the home. The information provided via the surveys was a little mixed with two people ticking always, one usually, two sometime and one person abstaining altogether in response to the question about social activities and their suitability. In addition to the visitor spoken with in the lounge, other visitors were observed entering and leaving the home throughout the day or socialising with their next-ok-kin in the communal lounges or their bedrooms. Details of the homes visiting arrangements can be found within the service users guide and statement of purpose literature, the latter document accessible to people within the main hallway. On entering and leaving the home visitors are invited to date and sign the visitors register, which provides both an indication of the people in the home in the event of the need to evacuate and a record of the people visiting the service. The care planning records, as discussed earlier in the report reflect peoples choice over rising and retiring times, their terms of address and generally their wishes with Care Homes for Older People Page 18 of 32 Evidence: regards to the delivery of personal care. A look around the home established that people were using personal items to individualise their bedrooms and thus creating a sense of ownership and belonging. Information, taken from the residents surveys, indicate that people generally feel they receive both the care and support they require and that the staff are available to help them when required, listen to their requests and respond appropriately. However, the surveys, again produced a mixed reaction in respect of the meals served at the home, with two people ticking always, two usually, one sometimes and one person abstaining from answering the do you like the meals at the home. Peoples comments also varied with one person stating: very basic and uninviting, whilst another person commented very good. The meal served during the fieldwork visit appeared to be well presented and people spoken with during the visit indicated that they had enjoyed their diner. The manager indicated during a discussion, that residents meetings offer people the ideal opportunity to discuss concerns or observations with the homes menus and the meals provided but feedback was generally positive. The member of the catering staff team on duty during the visit was able to confirm that she had completed food hygiene training. She also discussed the menus and showed us the records maintain in respect of the food served and the equipment checks undertaken. The food storage facilities were appropriate and provided sufficient dry, cold and frozen food storage and there was a range of catering and/food items available. The kitchen had recently been refitted and appeared to be well set out and functional. Care Homes for Older People Page 19 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. Evidence: The service state via the AQAA that: We have robust policies in place to ensure that our service users are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self-harm, inhuman or degrading treatment, through deliberate intent, negligence or ignorance, in accordance with written policies. Our staff are trained to detect and report any signs of abuse. New staffs are recruited only after receiving satisfactory references and have a clear CRB and POVA first report. Our service users are aware of the complaint procedure and are aware of their rights and how to voice their opinion. Complaints received are dealt with in a timely manner. Details of the homes complaints process are contained within the service users guide and statement of purpose literature and these documents are made accessible to service users and their representatives. The dataset, which forms part of the AQAA documentation, confirms the existence of Care Homes for Older People Page 20 of 32 Evidence: the homes complaints and concerns procedure, which was last reviewed and updated in the September of 2007. The dataset also contains information about the homes complaints activity over the last twelve months: No of complaints: 1. No of complaints upheld 1. Percentage of complaints responded to within 28 days: 100 . No of complaints pending an outcome: 0. Information taken from the service user and staff surveys indicate that people moving into the home are aware of the homes complaints process and whose attention complaints should be brought to, whilst the staff indicate that they are aware of how to support people raise concerns or complaints. A training matrix, produced and maintained by the manager, was seen during the fieldwork visit. This document indicates that staff attended a Safeguarding Adults Awareness session in the April of 2008 and that a refresher is planned annually. The staff to complete the survey also felt the training provided at the home was relevant to their role and that it kept them abreast of new ways of working. The homes tells us, via their AQAA and dataset, that policies on the protection of service users are in place, Safeguarding adults and the prevention of abuse and Disclosure of abuse and bad practise, both policies updated in the September of 2007. The dataset also establishes that over the last twelve months no safeguarding referrals have been made to the Local Authority or Commission for social Care Inspection. Care Homes for Older People Page 21 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: The manager states via the AQAA that: We provide a safe and well-maintained environment for our service users and Waxham House is clean, pleasant, odour free home. Our service users have access to safe and comfortable indoor and outdoor communal facilities and they have sufficient and suitable toileting and washing facilities. Our service users have comfortable bedrooms and are encouraged to bring their own possessions to make their room more homely. A look around the home was undertaken in the company of the manager, who discussed recent alterations/changes and improvements that have been made to the service: two rooms being redecorated Room 2 and Room 6a, new carpet being laid in Room 6a, the kitchen has been upgraded and refurbished and a New Call System installed. The manager also discussed the providers plans to redecorate the downstairs assisted bathroom, however, as mentioned earlier within the report the service users would like Care Homes for Older People Page 22 of 32 Evidence: an assisted shower or wet room created during the redecoration of this facility. Generally the home was found to be in a good decorative condition, well furnished and suited to the needs of the people residing within the home. A maintenance person now works for the providers, spending time at both Waxham House and their sister home and minor repairs and re-decorative works can be undertaken by this person. The dataset establishes that domestic appliances and personal equipment is regularly maintained and serviced by external agencies / bodies. Information taken from the service users surveys indicate that people feel the home is generally fresh and clean, four people ticking always and two usually, in response to this question. Domestic staff were observed during the visit undertaking their duties. The home was noted to be free from odours and clean and tidy throughout. Communal toilets and bathrooms were noted to contain liquid soaps, paper-towels and bins for the disposal of waste. All chemicals were stored in accordance with the Control Of Substances Hazardous to Health (COSHH) regulations. The laundry is located within the main building and the staff are responsible for laundering residents clothing and returning this to the client room. Clothes are labelled to reduce the possibility of lose or the item being returned to the wrong person. Care Homes for Older People Page 23 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. Evidence: A copy of the homes duty roster was seen during the fieldwork visit and indicated that sufficient care and domestic staff are on duty to meet the needs of the service and the service users. The roster establishing that each shift is covered by a minimum of two care staff, plus a domestic staff, cook, member of the management team and part-time maintenance person. Observations made throughout the day support the fact that sufficient staff were employed at the home and that the needs of the service users were being meet, with care staff, domestic and catering staff all seen around the home during the fieldwork visit. In discussion with the manager the issue of staff shortages were discussed, the manager explaining that the home had recently experienced a drop in staff numbers, Care Homes for Older People Page 24 of 32 Evidence: which had meant people picking up additional shifts to cover the home. However, she has recruited several new staff, one of whom was meet during the visit, as she was on her induction, which the manager is confident will ease the pressure on the existing staff team. Information, taken from the residents surveys, as evidenced earlier in the report, indicate that people generally feel they receive both the care and support they require and that the staff are available to help them when required, listen to their requests and respond appropriately. In discussion with staff access to training was considered to be good and the general atmosphere within the home and peoples relationships with each other and the service user group considered to be good. Training records are available and a matrix system is in place to document and track both the training sessions completed and the dates that updated training sessions are to be undertaken. The training records identify that the staff are completing courses of both a mandatory nature, food hygiene, fire safety, moving and handling and skills development courses, mental capacity act, safeguarding awareness, etc. Information taken from the dataset and confirmed with the manager, indicates that currently the home employs eleven care staff. Nine of the eleven has completed a National Vocational Qualification (NVQ) at level 2 or above and this provides the home with a rate of 82 of its care staff possessing an NVQ at level 2 or above. The dataset also indicates that the remaining two staff are completing their NVQ, which would increase the percentage of staff holding an NVQ level 2 or equivalent to 100 , if the current staff team remain stable. Information contained within the dataset establishes that a recruitment and selection strategy/procedure exists to support the manager when employing new staff. It also indicates that all of the people who worked in the home over the last twelve months have undergone satisfactory pre-employment checks. On reviewing the files of four newly recruited staff all of the required checks were in Care Homes for Older People Page 25 of 32 Evidence: place, Criminal Records Bureau (CRB) checks, Protection Of Vulnerable Adults (POVA) checks and two references. The files also contained completed application forms, health declarations, photographs of the employee, interview summaries, personal information and information used to support the CRB application process. Feedback provided by the staff, through the surveys, establishes that they feel they had completed a thorough recruitment process before starting work at Waxham House. Care Homes for Older People Page 26 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: The service indicate via the AQAA that: The manager is skilled and competent to manage the day-to-day operations of the care home, and possesses a National Vocational Qualification (NVQ) level 4 in care and The Registered Managers Award (RMA). The manager supports the ethos of lifelong learning and is committed to her professional development and that of the staff team. The manager is supported by a deputy manager and delegates effectively to her deputy. The manager is also supported by the proprietors one of whom possesses the Registered Managers Award (RMA) in the management and administration of Waxham House. Care Homes for Older People Page 27 of 32 Evidence: Information taken from the staff surveys indicate that the manager is meeting with her staff team from time-to-time to provide supervision and support, whilst the people spoken with during the fieldwork visit confirmed that staff meetings occur on a relatively regular basis. Minutes of the meetings held with the staff are accessible within the home, the last meeting recorded on the 02 October 2008. Each meeting is advertised in advance the manager stating that she prepares and agenda of items to be discussed before putting up posters informing the staff of the forthcoming meeting. As stated the manager is supported in the day-to-day management of the home by her deputy, who shares on-call duties and other delegated tasks. The deputy manager was met during the fieldwork visit, as she was on duty, the deputy manager taking on the management of the home during our visit, freeing the manager up to conduct the inspection. It has already been established that the manager arranges both residents and staff meetings, which are useful quality assurance tools. The manager has however, also devised a number of quality audit surveys for circulation to key groups involved in the home: the service users, their representatives / relatives and professional visitors. During the visit the manager was able to produce six responses from professional sources to her initial surveys, the manager stating that she had trialled the questionnaire with this group before reviewing the information and preparing to use the surveys with the other key user groups. Regulation 26 visits are being undertaken by a member of the Calibre management consultancy and in addition to the completion of the visit the visiting consultant is also producing action plans for the manager to work towards, which are aimed at improving the service for the service user group. The monies or accounts of three service users were reviewed during the fieldwork visit. The homes management and storage of residents monies was considered safe and appropriate, with peoples monies held individually and separate accounts or books maintained of the amounts stored. The books or accounts are regularly audited by the manager who signs to confirm completion of her audit, all transactions were double signed and have an accompanying receipt. The service tells us, via the AQAA and dataset information that health and safety Care Homes for Older People Page 28 of 32 Evidence: policies and procedures are made available to the staff and that domestic appliances and personal equipment is regularly maintained and serviced. Health and safety training is being made available to staff, with the training matrix and plan providing evidence of the courses attended and those to be attended by staff, including: health and safety, infection control and moving and handling, etc. The look around the home identified no immediate health and safety issues, and the environmental risk assessments do consider both potential areas of harm and how these can be managed. Personal Protective Equipment (PPE) was seen being used by the staff, who the manager stated have access to gloves, aprons, etc. Equipment is also available to assist in the care and support of the service users, with portable hoists, chairlifts, wheelchairs, etc all seen during our time in the home. Generally the service users and their relatives are satisfied with the service being provided at the home and raised no concerns in relation to either Health or Safety issues. Care Homes for Older People Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 The manager should seek advice on the homes current controlled drugs cabinet and the guidance provided within the Safe Custody Regulations. Care Homes for Older People Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). 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